Children's Mercy Hospital, Kansas City, MO, USA.
School of Medicine, University of Missouri, Columbia, MO, USA.
J Telemed Telecare. 2021 Jul;27(6):376-381. doi: 10.1177/1357633X19874200. Epub 2019 Sep 16.
Primary care provider (PCP) competency in dermatology is inadequate despite the high volume of patients with skin conditions. Better education and access to dermatology expertise is vital to improve patient care. We present a comprehensive case-based evaluation of Dermatology Extension for Community Healthcare Outcomes ECHO) sessions, an innovative videoconferencing educational model, by determining the diagnostic and treatment accuracy of dermatological conditions by PCPs over a 2-year period.
This is a retrospective cross-sectional study evaluating the use and impact of Dermatology ECHO over a 2-year period. Outcomes assessed include patient demographics, PCPs' diagnostic accuracy, and expert treatment impact. Results were analysed using summary statistics and Pearson's chi-square test to describe the adult and paediatric populations.
One hundred and sixty-seven adult cases and 56 paediatric cases were presented in 2016-2017. Among the 223 cases, 137 adult and 44 paediatric cases were complete and eligible for analysis. The mean lesion duration was 3.3 years in adults and 2.9 years in children prior to presentation. Upon case presentation, almost half (43.8%) of the adult cases were incorrectly diagnosed by their PCP with 18.8% receiving a partially correct diagnosis. PCPs had greater diagnostic accuracy in children (45% correct diagnosis, 27.5% partially correct, 27.5% incorrect). Expert treatment recommendations benefited 83.6% of adult cases and 72.5% of paediatric cases.
This study highlights the need for better dermatology access and teaching opportunities among PCPs in Missouri. Dermatology ECHO provides a platform for didactic learning and case presentations to improve dermatology competency among PCPs.
尽管有大量的皮肤状况患者，但初级保健提供者（PCP）在皮肤病学方面的能力仍然不足。更好的教育和获得皮肤病学专业知识对于改善患者护理至关重要。我们通过确定 2 年内 PCP 对皮肤科疾病的诊断和治疗准确性，对基于案例的皮肤科扩展社区医疗保健结果 ECHO（Dermatology Extension for Community Healthcare Outcomes ECHO）会议的综合评估，这种创新的视频会议教育模式进行了介绍，这是一种创新的视频会议教育模式。
这是一项回顾性横断面研究，评估了在 2 年内使用和影响皮肤科 ECHO 的情况。评估的结果包括患者人口统计学数据、PCP 的诊断准确性以及专家治疗的影响。使用汇总统计数据和 Pearson 卡方检验来描述成人和儿科人群的结果。
2016 年至 2017 年期间共提出了 167 例成人病例和 56 例儿科病例。在 223 例病例中，有 137 例成人病例和 44 例儿科病例完整且符合分析条件。在提出病例之前，成人的平均病变持续时间为 3.3 年，儿童为 2.9 年。在病例提出时，近一半（43.8%）的成人病例被他们的 PCP 误诊，其中 18.8%得到部分正确诊断。PCP 在儿童中的诊断准确性更高（45%的正确诊断，27.5%的部分正确诊断，27.5%的错误诊断）。专家治疗建议使 83.6%的成年病例和 72.5%的儿科病例受益。
这项研究强调了密苏里州的初级保健提供者需要更好的皮肤病学机会和教学机会。皮肤科 ECHO 为 PCP 提供了一个教学和病例展示的平台，以提高他们在皮肤病学方面的能力。
